Scribd
Upload
6 views2 pages

Applicant Data Sheet Template

The document is a data sheet for a main applicant, gathering personal information such as name, contact details, citizenship, education, and profession. It also includes questions regarding residence permits, criminal history, and medical conditions. This information is essential for processing applications related to residency or permits.

Uploaded by

kais.yona26
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
6 views2 pages

Applicant Data Sheet Template

The document is a data sheet for a main applicant, gathering personal information such as name, contact details, citizenship, education, and profession. It also includes questions regarding residence permits, criminal history, and medical conditions. This information is essential for processing applications related to residency or permits.

Uploaded by

kais.yona26
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

DATA SHEET

Name of Main Applicant: …………………………………….

General Information about the Applicant


Main Applicant or Kinship to Main Applicant (Spouse / Child)
Family Name (as per passport):
First Name(s) (as per passport):
Family Name at Birth:
First Name(s) at Birth:
Mother's Family Name at Birth
(Mother’s Maiden/Before marriage Family Name):
Mother’s First Name(s) at Birth
(Mother’s Maiden/Before Marriage First Names):
E-mail:
Phone Number:
Gender (male/female):
Marital Status (single/married/widowed/divorced):
Date of Birth (dd/mm/yyyy):
Place of Birth (city/town and country):
Citizenship (all in case of dual or multiple):
Last Permanent or Habitual Residence (FULL address): Country:
City/Town:
Street, House
Number:
Qualification/Profession(s):
Highest Level of Education (primary/secondary/higher
education):
Occupation:
Passport Type (ordinary / service / diplomatic / refugee / other):
Passport Number:
Passport Issue Date (dd/mm/yyyy):
Passport Issue Place (country, city):
Passport Expiry Date (dd/mm/yyyy):
(Must be valid for the desired validity of the RP + 3 months)
Languages Spoken (please include what level): 1st Language:
Level of 1st Language
(basic/middle/advanced):
2nd Language:
Level of 2nd Language
(basic/middle/advanced):
Do you have a valid residence permit in another country?
(yes/no)
If yes, what type of permit? Type:
Number of the issued permit? No.:
Expiry date of the permit? Expiry date:
Has your application for residence permit ever been refused?
(yes/no)
Have you ever been convicted for a crime? (yes/no)
If yes, in which country? Country:
When (please provide date)? Date:
(dd/mm/yyyy)
What kind of crime have you committed? Crime:
What kind of penalty was imposed? Penalty:
Have you ever been expelled from ……………….. (yes/no)
If yes, when? Date:
(dd/mm/yyyy)
Are you aware of any disease or medical condition (such as
HIV/ AIDS, tuberculosis, Hepatitis B, syphilis, leprosy, typhus)
you have? Do you carry any of the following contagious
diseases: HIV, Hepatitis B, typhus or paratyphus? (yes/no)
If you are suffering from any of the above specified
contagious diseases or medical conditions, do you receive
an obligatory and regular medical treatment? (yes/no)

You might also like